This survey shows surprisingly few differences between Chinese medical and non-medical students in smoking prevalence and in beliefs about smoking. However, medical students who smoked were more likely to be occasional smokers. Thus, it seems that medical education, or being prospective physicians, has some effect on the students' smoking behavior, but the effect is limited to the modification of cigarette consumption level and has no significant impact on the decision to smoke.
Before addressing the implications of these results, one must ascertain whether the large proportion of occasional smokers found among medical students results from the analytical approach taken for this study. One might argue that the definition of ‘smoking’ was too inclusive (smoking at the time of survey) since it would count even experimenters as smokers. However, even if ‘having smoked ≥100 cigarettes’ were added to the definition, the proportion of occasional smokers among medical students would still be 65.8%, significantly greater than the 52.4% among non-medical students (p < 0.01). If ‘started smoking 5 years ago’ were added, the proportion of occasional smokers among medical students would be 76.4%, as opposed to only 59.4% among non-medical students (p < 0.01). Moreover, a series of international studies of medical students, using the World Health Organization's recommended questionnaire, also found a high percentage of occasional smokers. Studies in Australia and in nine Asian countries found that at least 70% of current smokers among medical students were occasional smokers (Tessier et al., 1992; Richmond and Kehoe, 1997). Surveys in European, African and Middle-Eastern countries also found that about 45–60% of current smokers among medical students were occasional smokers (Tessier et al., 1989; Tessier et al., 1992). Thus, occasional smoking is an established phenomenon among medical students. What the present study has added is that the proportion of occasional smokers is much higher among Chinese medical students than among non-medical students.